Our Summary

This research paper looks at the occurrence of rare cancers in children after they have had a bowel transplant. The study examined 90 children who had this surgery at Birmingham Children’s Hospital between 1989 and 2017. They found that about 5% of the children developed unusual cancers in unexpected places. These included a brain tumor linked to a virus (EBV), two cases of a tumor (SMT) located near the surgical site and in the neck/thoracic area, and a rare cancer of the blood vessels (angiosarcoma) in the abdomen. Unfortunately, the outcomes were poor for most of these children, except for one with an SMT who is doing well after receiving T-cell therapy. The paper concludes that doctors need to be aware of the potential for these rare cancers in children who have had bowel transplants, so they can diagnose and treat them as early as possible.

FAQs

  1. What percentage of children developed unusual cancers after bowel transplants according to the study conducted at Birmingham Children’s Hospital?
  2. What types of rare cancers were found in children who had bowel transplants?
  3. What is the study’s recommendation for doctors regarding the risk of rare cancers in children who have had bowel transplants?

Doctor’s Tip

A doctor might tell a patient receiving an intestinal transplant to be vigilant about any unusual symptoms or changes in their health, as rare cancers can occur after the surgery. Regular follow-up appointments and monitoring are essential for early detection and treatment of any potential issues. It is important to communicate any concerns or symptoms with your healthcare team promptly.

Suitable For

Patients who are typically recommended for intestinal transplant are those with severe intestinal failure who are not able to absorb nutrients or fluids properly, despite medical therapy. This can be due to a variety of reasons, including short bowel syndrome, motility disorders, chronic intestinal pseudo-obstruction, or complications from previous surgeries. Patients may also be considered for intestinal transplant if they have complications from parenteral nutrition, such as liver failure or frequent infections.

In general, patients who are being considered for intestinal transplant should have exhausted all other treatment options and have a poor quality of life due to their intestinal failure. They should also have a good support system in place to help them through the transplant process and post-transplant care.

It is important for patients and their healthcare providers to carefully weigh the risks and benefits of intestinal transplant, as it is a complex and high-risk procedure. Patients with certain medical conditions or factors, such as active infections, severe heart or lung disease, or certain types of cancers, may not be good candidates for intestinal transplant. A thorough evaluation by a multidisciplinary team of healthcare providers is typically required to determine if a patient is a suitable candidate for intestinal transplant.

Timeline

Before intestinal transplant:

  • Patient is diagnosed with a severe intestinal disorder or disease that cannot be managed with traditional treatments
  • Patient undergoes extensive medical evaluations and testing to determine if they are a candidate for a transplant
  • Patient is placed on a waiting list for a donor intestine
  • Patient may experience complications from their underlying condition, such as malnutrition, infections, and organ failure
  • Patient may require long-term hospitalization and medical interventions to manage their symptoms

After intestinal transplant:

  • Patient undergoes the transplant surgery, which involves removing the diseased intestine and replacing it with a healthy donor intestine
  • Patient is closely monitored in the hospital for complications such as rejection, infection, and organ failure
  • Patient requires intensive post-operative care, including medications to prevent rejection and support the new intestine
  • Patient undergoes regular follow-up appointments and testing to monitor the function of the transplanted intestine and overall health
  • Patient may experience complications related to the transplant, such as infections, rejection episodes, and side effects from immunosuppressive medications
  • Patient may require ongoing medical management and support to maintain the health of the transplanted intestine and prevent complications.

Overall, the process of intestinal transplant is complex and challenging, but for many patients, it offers hope for improved quality of life and long-term survival.

What to Ask Your Doctor

Some questions a patient should ask their doctor about intestinal transplant include:

  1. What are the potential risks and complications associated with intestinal transplant surgery?
  2. How long is the recovery period after the surgery and what can I expect during this time?
  3. What medications will I need to take after the transplant and what are the potential side effects?
  4. How often will I need to follow up with my transplant team after the surgery?
  5. Are there any long-term effects or complications I should be aware of following an intestinal transplant?
  6. How will the transplant affect my overall quality of life and daily activities?
  7. Are there any specific dietary or lifestyle changes I will need to make after the transplant?
  8. What signs or symptoms should I watch out for that may indicate complications or rejection of the transplant?
  9. How will the transplant impact my immune system and my susceptibility to infections?
  10. Are there any support groups or resources available for patients who have undergone an intestinal transplant?

Reference

Authors: Gerlach UA, Morland B, Hobin D, Nagy A, Sharif K, Mirza DF, Gupte GL. Journal: Pediatr Transplant. 2020 May;24(3):e13697. doi: 10.1111/petr.13697. Epub 2020 Mar 25. PMID: 32212293